Facelift (Rhytidectomy)in Boston, MA.

Facelift

What is a Facelift?

A facelift, also known as a rhytidectomy, in Boston and Worcester, Massachusetts, is a procedure aimed to improve various signs of aging, which result from many factors such as stress, gravity, and hereditary aspects. A facelift corrects sagging or loose skin in the lower half of the face, deep creases along the corners of the mouth and lower eyelids, and loose skin or fatty areas under the chin and jaw.

Am I a good candidate for facelift surgery?

Generally, good candidates for a facelift are those who suffer from excess skin or sagging on the lower face and neck, possess quality skin elasticity, and have strong bone structure. Healthy men and women who are non-smokers and have realistic expectations for the outcome of their surgery can expect to see optimal results.

Blepharoplasty – Patient 118

A nurse in her early 50’s who had some visual field obstruction from her upper eyelid skin and brow ptosis. She is shown before and again, 7 weeks after bilateral upper eyelid blepharoplasty combined with a brow-pexy procedure. The brow pexy stabilizes the lateral eyebrows and prevents them from dropping further. It can be helpful in cases where a patient has brow ptosis ( drooping of the eyebrows) but does not want a formal brow lift.

A woman in her early 70’s who is bothered by an aged appearance and laxity of her neck skin. She has significant sun damage and was a smoker in the past, but has not smoked for more than 6 years. Examination shows significant volume loss around the eyes and cheeks from the aging process, and her left cheek is much deeper than her right. She also has a weak chin.
She is shown before and again, 6 months after a facelift, including a chin implant and fat grafing to her midface and upper eyelid sulcus to treat the aging related hollowing of her eyes. She also has had some Restylane Lyft to her cheeks after surgery.
Discussion: The poor quality of her skin from years of smoking and the sun damage will limit the result that we can obtain from a facelift. Her skin elasticity is quite poor. It is not just the tailor but also the fabric that we are working with that influences the result. But the fat grafting can improve the volume loss and may bring in stem cells that improve the quality of the skin. When a chin is weak, a chin implant can also dramatically improve the results. Fat grafting is unpredictable- even though significantly more fat was placed to her hollower left cheek at the time of surgery, it still remains hollower. It is common to “build the foundation” with the fat grafting and then return at 6-12 months and add a some of the non animal stabilized hyaluronic acid (NASHA) fillers such as those in the Restylane/Juvederm families to further improve the results. A patient with prominent creases of the skin from poor elasticity is prone to “jokers lines”-and upward sweep of the skin lines at the corners of the mouth. This has been limited in her case by the fat grafting at the time of her surgery to replace volume loss in these areas.

A woman in her early 60’s who is bothered by an aged appearance of her face. She is shown before and again, 9 weeks after bilateral upper eyelid blepharoplasty with facelift utilizing a platysma window and lateral SMAS plication, combined with fat grating to the cheeks and upper and lower eyelids. The fat grafting improves the quality of the skin, but also helps to correct the “a frame” hollowing of her upper eyelids that adds to her aged appearance. She has significant volume loss of the cheeks with aging that is not corrected with skin tightening- it is corrected by the careful replacement of volume with fat grafting.

A woman in her mid 70’s who is bothered by an aged appearance. She has also lost 100 lbs following a gastric bypass. Analysis of her face shows some brow asymmetry as she holds her left brow higher to compensate for some left eyelid ptosis. She has prominent fat pads of the lower eyelid and significant volume loss of the midface. A weak chin contributes to the laxity of her neck, and the vertical lines around her lip bother her as well. She is shown before and again, 3 months after bilateral upper eyelid blepharoplasty, bilateral lower eyelid blepharoplasty, lateral smasectomy face lift with placement of a chin implant, fat grafting to the midface and perioral dermabrasion. She is thrilled with her natural but markedly improved appearance. Dermabrasion is an “old fashioned” technique that works well to improve the vertical lines of the lip without as much a risk of bleaching of the skin that can be seen with laser or deep chemical peels. She has a natural look because our procedure was tailored to fit her aging deformity. We have “lifted and filled” not just pulled her tighter. The key to a natural appearance with facial aging is a careful diagnosis and then correction of the different components of the aging deformity- there is not one key that fits all locks.

A woman is shown before and again 7 months after facelift combined with a chin implant. When a patient with a "weak chin" is requesting a facelift or a rhinoplasty, a chin implant is typically recommended at the same time to improve the subsequent facial balance and results.

What are my options for a facelift?

There are multiple methods to a facelift, including the traditional facelift, the limited incision facelift, and a neck lift. A traditional facelift involves an incision from the hairline at the temples to the lower scalp. An additional incision under the chin may be required to tighten loose skin on the neck. A limited incision facelift calls for shorter incisions at the temples, which may extend under the lower eyelids or upper lip. Lastly, a neck lift involves incisions starting in front of the earlobe and extending behind the ear to the lower scalp. Dr. Hall will advise you in which type of facelift is right for you, based on the degree of change you would like to see.

Facelift surgery can be performed under a local anesthetic or general anesthesia. When local anesthetic is used, the patient is awake but does not feel any pain, while general anesthesia causes the patient to “sleep” during the surgical procedure. The outcome of facelift surgery is the same, despite which option patients choose.

What should I expect during recovery?

Downtime associated with a facelift varies on the type of facelift performed, though most patients take two weeks to heal. Patients will experience bruising and swelling around the ears, and bandages are wrapped around the incision sites to minimize swelling. Most patients feel minimal discomfort during recovery, though a dull ache behind the ears may occur. Medication is provided for a comfortable recovery.

It is advised that patients refrain from strenuous activities for a minimum of three weeks after surgery, and athletic activities for six weeks. While recovering, it is important to keep the head elevated while sleeping to ensure desired results.

“Dr. Hall and all of his staff are very welcoming and supportive. In addition, I am extremely pleased with the results of my procedure. I have already referred a friend to Dr. Hall!”